The nature of healthcare businesses requires that healthcare organizations perform a financial clearance prior to or when the patient arrives at their facilities for their services. The amount of work and tasks associated with each healthcare organization's service can easily surpass the number of resources available to properly address all the follow up tasks and issues. When issues or notifications are not addressed in a timely manner, it could result in the reduction or rejection of payment for the service, thus impacting the financial outcome for the organization. There are different ways that organizations could prioritize the work based on the type of service or procedure or the amount charged for the service. However, because of the nature of the healthcare business, the true monetary value of a service can vary widely depending upon the type of payer, the patient or subscriber's employer, and the location where the services are being delivered. Different payers' contractual rules result in different values for the same services. In most cases, the type and nature of a healthcare visit makes it very difficult to properly identify and value all of the services associated with a healthcare visit.
Moreover, currently available healthcare scheduling, registration, and other healthcare information systems do not provide a way to manage and prioritize and resolve activities and based on a monetary value of the services for a patient visit to a healthcare provider prior to the point in time that such services are rendered. This system provides a predictive valuation for the provided services prior to the performance of those services.
Thus, there is a need for Statistical financial system and method to value patient visits to healthcare provider organizations for follow up prioritization. Healthcare provider organizations have a critical financial need to identify problems with patient registrations and correct those problems in a timely fashion in order to prevent denials and rejections by the insurance company payers. Given time and resource constraints, it is important to not only identify the correct issues, but to prioritize and track those issues. A prioritization must be based on financial impact and the valuation of the visit based on services is an important feature. Again, given the time and resource constrains involved, having a predictive method to assign a value to services before they are rendered based on statistical methods, and thus creating a value for the patient visit is a unique and innovative solution.